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Tales of the Graves’ – Graves’ Disease Overview

Understanding Graves' Disease

Spooks and specters may cause quite a scare this season, but a far more real fright is not understanding one’s health condition. Grave’s disease can be a daunting subject, but after reading this brief breakdown of the condition you will be able to put your fears to rest. Having a better understanding of this autoimmune disorder will keep the ghosts of ignorance out of sight and out of mind.

What is Graves’ Disease?

Graves’ disease is an autoimmune disorder that can cause some serious issues, particularly relating to the thyroid, and often the eyes. This disorder occurs when the immune system incorrectly produces an overabundance of antibodies. These antibodies, specifically thyroptin receptor antibody (TRAb), mimic the effect of thyroid stimulating hormone (TSH). The primary function of TSH, a hormone produced by the pituitary gland, is to initiate and regulate production of thyroid hormones. Normally, the thyroid only receives signals from the pituitary gland via TSH, which regulates production of T3 and T4. This usually leads to a healthy balance of thyroid levels unless there are other factors leading to a thyroid condition.

When the thyroid is being directed by both the pituitary and the immune system, via the antibody acting like TSH, the thyroid tries its hardest to keep up with the increased demand. This causes the thyroid to become overworked and ultimately exhaust itself. Additionally, overproduction of thyroid hormones leads to nutrients being burned at an aggressive rate, reducing their impact on the body. Furthermore, these increased hormone levels lead to hyperthyroidism, which is common in those with Graves’ disease.

Graves’ disease is the leading cause of hyperthyroidism in the United States. Not only that, but it is also quite common. This autoimmune disorder, which is found 5-10 times more in women, is recognized as affecting roughly 10 million people.

Symptoms of Graves’ Disease

The most common and easily recognizable symptom of Graves’ disease is protruding or seemingly bulging eyes. This is caused because of increased pressure and swelling due to inflammation within the eye socket. In rare cases Graves’ disease can also cause reddish thickening of the skin on the front of the patient’s shin, also known as pretibial myxedema. It is likely caused by antibodies attacking the skin. Other Symptoms Include:

  • Irritability
  • Anxiousness
  • Muscle pain and Weakness;
  • Insomnia
  • Increased Appetite
  • Weight
  • Rapid or Irregular Heartbeat
  • Heat Intolerance
  • Diarrhea or frequent bowel movements
  • Change in menstrual cycle
  • Erectile dysfunction or reduced libido

A number of the preceding symptoms are shared with hypothyroidism. If you experience these it may be pertinent to speak to your physician about running a full thyroid panel to cover both conditions. This test gauges one’s levels of T4, Free T3, Reverse T3, TSH, and thyroid antibodies (this includes antithyroglobulin antibody and anti-thyroperoxidase [TPO] antibody). It is of great importance not to treat just the symptoms but also resolve any underlying autoimmune disorders, such as Graves’ disease, that may have led to hyperthyroidism or related thyroid conditions.

Graves’ Ophthalmopathy

Of specific concern for those who have Graves’ disease is eye health. Roughly 5% of patients with this disorder experience severe opthalmopathy. The hyperactive thyroid element of this condition does not interact with the eyes, but as an autoimmune disorder this disease actively attacks the body instead of helping to defend it. Antibody attacks initiated by the immune system cause damage to the TSH receptors, eye muscles, and tissues within the eye socket, which causes damage to the eye itself.

Many people with Graves’ disease, or thyroid conditions in the eyes, experience some degree of swelling, inflammation, and scarring in and around the eye socket. This can lead to a number of detrimental conditions with related symptoms. An inability to completely close one’s eyelids causing the cornea to dry out and leave it unprotected, muscle weakness making it difficult and sometimes painful to move the eyes. It is also common to experience pressure on the optic nerve, the link between the eyes and the brain, causing blurred vision and/or color blindness. In severe cases this damage can become permanent if not treated appropriately.

Treatment

There are a handful of standard treatments for Graves’ disease. Most common of these is radioiodine therapy. Through this treatment thyroid cells are slowly destroyed by radiated iodine in an attempt to reduce production of thyroid hormones. This method has been practiced for over 50 years and no serious complications have been recognized. Unfortunately, there is a risk that after treatment, one will become hypothyroid, sub-optimal functioning thyroid.

Another plausible means of treatment is partial thyroidectomy. This procedure involves surgically removing a portion of the thyroid gland in order to regain hormonal balance. In much the same way that radioiodine therapy resolves the issue of overproduction, a partial thyroidectomy reduces the thyroid’s ability to produce excessive amounts of thyroid hormone. The surgical option is usually limited to those who are pregnant and are unable to tolerate antithyroid medications or people who do not want to go through radioiodine therapy but desire a permanent, one-time treatment.

Alternatively, antithyroid drugs, such as propylthiouracil (PTU) and methamazole, may be prescribed. However, these come with significant side effects including liver damage, rash, hair loss, vertigo, jaundice, aplastic anemia, and hepatitis. For this reason, it may be worthwhile looking into alternatives before risking these dramatic side effects. Hypothyroidism may occur from usage of any antithyroid drugs but radiation treatments and surgery have a greater chance of causing it.

Low Dose Naltrexone (LDN) may be prescribed in lieu of other methods. LDN is inexpensive and comes with nearly no side effects. It has become widely utilized in treatment of autoimmune disorders for its ability to impede cells that cause autoimmune conditions and assists in reducing inflammation and the release of neurotoxins in the brain. It is also useful in preventing overproduction of antibodies, a prominent factor in Graves’ disease.

Supplements may also be useful in treating autoimmune conditions. For example, selenium reduces antibodies and promotes reduction of inflammation. L-carnitine assists your body with the cellular demands brought on by hypothyroidism. For those with an autoimmune disorder, maintaining high levels of vitamin D, within in the 75th percentile, can be very beneficial.

The Root of the Issue

Because autoimmune diseases can be difficult to diagnose and are regularly hiding under many other symptoms it is important to understand them fully. By removing the veil of confusion obscuring Graves’ disease one is able pursue proper treatment and understand why it is the correct approach. Combating autoimmune disorders at their source will help ensure that it won’t come back to haunt you again.

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